Billing Specialist - Senior

Description
Responsible for office, out-patient, and inpatient physician coding. Provides education regarding documentation requirements to improve coding quality and ensure accurate and complete capture of revenue.

Responsibilities
1. Implements and manages outpatient and provider coding process for inpatient and outpatient physician services.
2. Validates and determines appropriate coding levels by obtaining and reviewing clinical documentation.
3. Compares and reviews charge tickets, both manually and system generated, to clinical documentation to ensure that all charges for procedures and related services have been accurately documented and captured.
4. Ensures that documentation supports charges to prevent denials/underpayments and to ensure adherence to compliance standards.
5. Follow-up on missing charge tickets and clinical documentation as appropriate.
6. Develop educational materials and policies/procedures to assist providers with the new regulatory or payer policies.
7. Identifies and assists with implementation of documentation and revenue enhancement opportunities.
8. Collaborates with clinical staff to identify and implement appropriate documentation and coding modifications.
9. Reviews and distributes coding related information to clinical staff, including CPT and ICD-9 code changes, medical necessity policies, coding /billing information regarding new procedures and pharmacy items.
10. Develops educational material and policies and procedures to assist providers with understanding new regulatory or payer policies as they relate to coding changes.
11. Assists in the development of fee schedule updates.
12. Responsible for resolving any coding related errors, edits and denials that are identified by the physician practices or practice billing system.
13. Consults and provides feedback with front line clinical staff, administrators and financial counselors to identify reimbursable indications for treatment.
14. Continuously reviews revenue cycle with management team and supervisor.
15. Participates in education programs to maintain up to date coding skills.
16. Participates with the Compliance Department in random chart audits to ensure appropriate documentation, coding and billing.
17. May prepare presentations for physician and staff practices as needed.
18. May oversee the work of less experienced staff.

Qualifications
Associates Degree or HS Diploma/GED plus two years of related medical coding experience
Four years of experience in medical practice or outpatient coding
Medical practice business office or patient accounts experience preferred.
Certification: CPC from accredited institution preferred

Employer Description

Strength Through Diversity

The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care.When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by:

Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach theirpotential.

Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experiencediscrimination.

Inspiring and fostering an environment of anti-racist behaviors among and between departments andco-workers.

We work hard to acquire and retain the best people and to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to professional advance. We share the belief that all employees, regardless of job title or expertise contribute to the patient experience and quality of patient care.

Explore more about this opportunity and how you can help us write a new chapter in our history!

“About the Mount Sinai Health System:

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism.”

EOE Minorities/Women/Disabled/Veterans

Compensation
The Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $27.6548 - $40.671 Hourly. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

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